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European Respiratory Society Annual Congress 2013 Abstract Number: 3139 Publication Number: P3950 Abstract Group: 4.1. Clinical respiratory physiology, exercise and functional imaging Keyword 1: Lung function testing Keyword 2: Surgery Keyword 3: Mechanical ventilation Title: Pulmonary function criteria in pre-operative evaluation for cardiac surgery Ana Sofia 26943 Santos [email protected] MD 1, Ricardo 26944 Coelho [email protected] MD 1, Raquel 26945 Rosa [email protected] MD 1, Alexandra 26946 Borba [email protected] MD 1,3, José 26947 Fragata [email protected] MD 2,3 and João 26951 Cardoso [email protected] MD 1,3. 1 Pulmonology Department, Hospital De Santa Marta, Lisbon, Portugal ; 2 Cardiothoracic Surgery Department, Hospital De Santa Marta, Lisbon, Portugal and 3 Faculdade De Ciências Médicas, Universidade Nova De Lisboa, Lisbon, Portugal . Body: Preoperative pulmonary function (PF) testing is often indicated in the evaluation of surgical candidates, especially if scheduled for thoracic and upper abdominal surgery. Patients (pts) submitted to non-resective thoracic surgery are traditionally considered high-risk if FEV1 < 1L (or <60% of predicted), FVC < 1,5L or DLco <60% of predicted. Yet, more recent publications suggest that these limits may be too conservative and that surgery can be safely performed in selected high-risk pts. The aim of this study was to evaluate the importance of pre-operative lung dysfunction in the outcome of pts submitted to cardiac surgery (particularly length of mechanical ventilation (MV)). Methods: Pts included in this study were pts evaluated for cardiac surgery (CABG and/or valvular) at our PF Laboratory. The variables evaluated were demographics, PF results and surgical variables and the differences between pts with or without lung dysfunction were analysed. Results: Thirty pts were studied (60% male, mean age 69y, 36,6% never smokers). Changes in PF were present in 70% of pts and 43,3% were high risk pts. The mean EuroSCORE II was 4,66% and 50% of pts underwent valve surgery, 33.3% CABG and 16.7% both procedures. Extracorporeal circulation was used in 83,3% of pts. Only 1 pt died. No single pulmonary function change in high risk patients was associated with increased MV time but these pts had longer length of hospital stay (7,8 vs. 11,7 days). Conclusions: The results in this study suggest that the criteria used to define high risk pts for non-resective thoracic surgery may be too restrictive and that a less conservative approach can be used when evaluating surgical candidates with pulmonary dysfunction..

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